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Volume comparison of radiofrequency ablation at 3- and 5-cm target volumes for four different radiofrequency generators: MR volumetry in an open 1-T MRI system versus macroscopic measurement

  • Hendrik Rathke , Bernd Hamm , Felix Guettler , Philipp Lohneis , Andrea Stroux , Britta Suttmeyer , Martin Jonczyk , Ulf Teichgräber and Maximilian de Bucourt EMAIL logo
Published/Copyright: June 9, 2015

Abstract

Introduction: In a patient, it is usually not macroscopically possible to estimate the non-viable volume induced by radiofrequency ablation (RFA) after the procedure. The purpose of this study was to use an ex vivo bovine liver model to perform magnetic resonance (MR) volumetry of the visible tissue signal change induced by RFA and to correlate the MR measurement with the actual macroscopic volume measured in the dissected specimens.

Materials and methods: Sixty-four liver specimens cut from 16 bovine livers were ablated under constant simulated, close physiological conditions with target volumes set to 14.14 ml (3-cm lesion) and 65.45 ml (5-cm lesion). Four commercially available radiofrequency (RF) systems were tested (n=16 for each system; n=8 for 3 cm and n=8 for 5 cm). A T1-weighted turbo spin echo (TSE) sequence with inversion recovery and a proton-density (PD)-weighted TSE sequence were acquired in a 1.0-T open magnetic resonance imaging (MRI) system. After manual dissection, actual macroscopic ablation diameters were measured and volumes calculated. MR volumetry was performed using a semiautomatic software tool. To validate the correctness and feasibility of the volume formula in macroscopic measurements, MR multiplanar reformation diameter measurements with subsequent volume calculation and semiautomatic MR volumes were correlated.

Results: Semiautomatic MR volumetry yielded smaller volumes than manual measurement after dissection, irrespective of RF system used, target lesion size, and MR sequence. For the 3-cm lesion, only 43.3% (T1) and 41.5% (PD) of the entire necrosis are detectable. For the 5-cm lesion, only 40.8% (T1) and 37.2% (PD) are visualized in MRI directly after intervention. The correlation between semiautomatic MR volumes and calculated MR volumes was 0.888 for the T1-weighted sequence and 0.875 for the PD sequence.

Conclusion: After correlation of semiautomatic MR volumes and calculated MR volumes, it seems reasonable to use the respective volume formula for macroscopic volume calculation. Hyperacute MRI after ex vivo intervention may result in the underestimation of the real expansion of the produced necrosis zone. This must be kept in mind when using MRI for validating ablation success directly after RFA. One reason for the discrepancy between macroscopic and MRI appearance immediately after RFA may be that the transitional zone shows no or only partially visible MR signal change.


Corresponding author: PD Dr. med. Maximilian de Bucourt, Dipl. Vw., Charité – University Medicine, Charitéplatz 1, 10117 Berlin, Germany, Phone: +49 30 450 627 085, Fax: +49 30 450 527 911, E-mail:

Acknowledgments

This research was kindly supported by the TSB – Technology-Foundation Berlin and the European Union (EU) – Fund for regional development. Thank you for you great work! We hope we worked out the comments to your satisfaction. Please feel free to contact us in any kind of further suggestions.

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Received: 2014-11-26
Accepted: 2015-5-7
Published Online: 2015-6-9
Published in Print: 2015-12-1

©2015 by De Gruyter

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